PDB74 Effective Health Care Budget Planning for Innovative Drugs in Diabetes Treatment in Turkey; From the Perspective of the Social Security Institution (SSI)

Abstract

Diabetes therapies constitute one of the highest budgets allocated by the Social Security Institution (SSI) each year in Turkey (within top 15). However, a standard budget allocation plan for reimbursement of innovative drugs in diabetes does not exist in Turkey. This study aims to offer a perspective for effective health care budget planning for innovative drugs in diabetes for the SSI in order to achieve patient access. Total budget spent by SSI for diabetes treatment is analyzed for the last three years. All treatment groups are defined for % unit and Turkish Lira (TL) growth and those values are investigated relative to the total diabetes budget. The current budget allocation structure for innovative drugs is defined and a new methodology is offered. The highest budget in diabetes is allocated for human insulin analogues with a total spending of 949,278,748 TL (45.7%), followed by glitazones 388,374,291 TL (18.7%) and sulphonylurea 244,190,634 TL (11.8%). However, the total budget allocated for innovative drugs as DPP-4 inhibitors and GLP-1 agonists is around 4.2%. The following steps for forward planning of budgets are proposed: Analysis of each treatment option within the same group with respect to effectiveness; defining reimbursement conditions (price-volume) for each option based on effectiveness; analysis of each treatment group with respect to effectiveness; defining budget allocated for each treatment group based on effectiveness; biannual review of the budget realizations. Re-evaluation of current therapies in terms of budget contributions and effectiveness may identify savings in SSI budget that could be freed up for new treatment options becoming available. A stepwise approach including the reevaluation of existing treatments in diabetes would be necessary in Turkey.